passmed 16/05

Question 1

Cerebral palsy how to manage pain and spasticity in legs?

Answer 1

oral diazepam
baclofen - muscle relaxant

inhibits release of excitatory neurotransmitters

Question 2

spastic cerebral palsy where is the lesion?

Answer 2

UMN
spastic: hemiplegia, diplegia /quadriplegia

increase tone

Question 3

athetoid movements and oro-motor problems - lip smacking etc is?

Answer 3

dyskinetic cerebral palsy
> damage to basal ganglia and substantia nigra

Question 4

cerebereller signs in CP

Answer 4

ataxic
cerebellum damaged

Question 5

how can you manage spasticity?

Answer 5

oral diazepam
intrathecal baclofem
botulinum toxin type a
orthopaedic surgery

Question 6

tet of fallot what signifies severity?

Answer 6

degree of pulmonary stenosis

whichh is the right ventricular outflow obstruction determining cyanosis

Question 7

TOF 4 defects are?

Answer 7

ventricular septal defect

right ventricular hypertrophy

right ventricular outflow obstruction(pulmonary stenosis)

overriding aorta

Question 8

ebstein anomaly

Answer 8

tricuspid valve leaflets are attached to walls of and septum of right ventricle

lithium use in first trimester is risk fcator

Question 9

characteristics of nephrotic syndrome?

Answer 9

proteinuria
hypoalbuminaemia
oedema

hyperlipidaemia
hypercoagulable state
predisposition to infection

Question 10

continuous machinery murmur?

Answer 10

PDA

Question 11

do innocent murmurs vary with position?

Answer 11

YES

Question 12

if patient has a pulse of 30 bpm
do you start CPR?

if unconscious

Answer 12

yes
15 chest compression to 2 breaths

Question 13

croup is caused by ?

what does it sound like?
management?

Answer 13

parainfluenza virus

barking cough - inspiratory stridor

give dexamethosone and if anything other than mild admit

Question 14

intense paroxysmal cough followed by loud high pitched whopping sound?
hwo to manage?

Answer 14

whooping cough caused by bordetella pertussis

macrolide - 10 days

Question 15

pyloric stenosis is the vomit bilious?

Answer 15

no it is not as it is from stomach - dummy

but meconium ileus > cystic fibrosis does have green vomit because it is small bowel obstruction

Question 15

investigate : pyloric stenosis?
abg results?
management?

Answer 15

abdo uss
hypocholraemic hypokalaemia alkalosis
ramstedt pyloromyotomy

Question 15

what is expressivity?

Answer 15

difficult to predict likely impact as genotype affceting phenotypic expression is variable

Question 16

what is in the 6 in 1

Answer 16

diphtheria
tet
pertussis
polio
haemophilus
hep B

Question 17

severe croup how do you manage?

Answer 17

supplemental oxygen - and
nebulised adrenaline - vasoconstrict of upper airway

reduces airway edema and improves airflow

Question 18

laryngomalacia

Answer 18

Congenital abnormality of the larynx.

Infants typical present at 4 weeks of age with:
stridor

Question 19

Plagiocephaly

Answer 19

Plagiocephaly is a skull deformity producing unilateral occipital flattening, which pushes the ipsilateral forehead ear forwards producing a ‘parrallelogram’ appearance. The vast majority improve by age 3-5 due to the adoption of a more upright posture

Question 20

what scan for stable meckles diverticulum?

Answer 20

technetium scan

technetium-99m pertechnetate scan

Question 21

what does a positive raised level of immunoreactive trypsinogen mean?

Answer 21

CF suspicios do sweat test

is a pancreatic enzyme release when there is damage to pamcreas

Question 22

hand foot and mouth disease is caused by?

Answer 22

coxsackie a16 virus

Question 23

fine punctate erythema sparing the area around the mouth

Answer 23

scarlet fever rahs
erythrpgenic toxin from alpha haemolytic streptococci

Question 24

fifth disease?

Answer 24

slapped cheek syndrome
parovirus b19

Question 25

what has a prodrom of fever, conjunctivits and fever?

rubella or measles?

Answer 25

measles

rubella pink maculopapular rash first presents on face then spreads

Question 26

DMSA (dimercaptosuccinic acid) scan

is a type of nuclear medicine imaging test that evaluates

Answer 26

identify kidney damage or scarring t

Question 27

west syndrome?

Answer 27

infantile spasm /colic looking

childhood epilepsy - serious

EEg abnormal

vigabtrin 1st line

Question 28

simple febrile convulsion

Answer 28

tonic clonic
focus of infection
<15 minutes
no reoccurence in 24 hours

Question 29

Steroid therapy should be given to all children who have an asthma attack

Answer 29

salbutamol inhaler and 3 days prednisolone

Question 30

what is a common complication of chickenpox?

Answer 30

secondary bacterial infection
NSAIds can complicate this
invasive group A streptococcal soft tissue sinfection = nectrosing fascitis

Question 31

what WCC would suggest septic arthritis?

Answer 31

ESR >40
WCC>12

Question 32

how to manage hypospadias?

Answer 32

surgical correction using foreskin remnants

Question 33

congenital diaphragmatic hernia

Answer 33

The presence of the liver in the thoracic cavity is a poor prognostic factor for CDH